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LIEN Foundation

Singapore’s first bioethics casebook, Making Difficult Decisions with Patients and Families was launched on 19 January 2014. It was enabled by The Lien Foundation, and conceived as an educational project in response to the findings of an earlier study (also funded by the Lien Foundation), What Doctors Say About Care of the Dying, which presented issues in the provision of complex multi-professional integrated care; decision-making dilemmas in patient care across acute, community and home care settings, and uncertainty about legal rules and principles in healthcare practice.

As a highly novel peer-to-peer professional educational initiative, the Singapore Casebook Project is a collaborative effort of more than 70 healthcare professionals in Singapore including co-authors, and is inspiring important conversations about supporting and improving healthcare ethics in Singapore and abroad, and its dissemination as an educational tool and resource for professionals in similarly developed healthcare systems is ongoing. The first edition of the Casebook was developed by a partnership of CBmE with The Hastings Center in New York and the Ethox Centre at the University of Oxford.

Made possible by a third gift to NUS by the Lien Foundation in 2015, the second edition of the Singapore Casebook proposes to focus on ethical challenges arising in “care transitions,” a frequent feature in the care of people with one or more chronic, often age-related conditions. We shall be adopting the same case-development process that we used in our previous project to produce 10 new case sets, with additional teaching and learning resources. Through our discussions with key stakeholders (including informal caregivers), we will ensure that our cases and supporting materials focus on the full range of ethical challenges that arise for those people who are involved in supporting people with chronic or long-term conditions in the hospital, community and home care settings.

When completed and incorporated into our Casebook website, these case sets will serve as an educational resource to support professional and non-professional caregivers in being able to recognize and think through the ethical challenges that they face in managing care transitions. Our new materials will also support formal and informal (university courses and modules, small group workshops or talks) education activities for professionals, allied healthcare workers, community volunteers and other caregivers. We shall also review and update all existing Casebook content and features, with close attention to relevant law and policy; and integrate the new cases into the book to create a comprehensive second edition, including site design and functionality features.